Adherence to secondary stroke prevention strategies - Results from the German stroke data bank

Only very limited data are available concerning patient adherence to antithrombotic medication intended to prevent a recurrent stroke. Reduced adherence and compliance could significantly influence the effects of any stroke prevention strategies. This study from a large stroke data bank provides representative data concerning the rate of stroke victims adhering to their recommended preventive medication. During a 2-year period beginning January 1, 1998, all patients with acute stroke or TIA in 23 neurological departments with an acute stroke unit were included in the German Stroke Data Bank. Data were collected prospectively, reviewed, validated and processed in a central data management unit. Only 12 centers with a follow-up rate of 80% or higher were included in this evaluation. 3,420 patients were followed up after 3 months, and 2,640 patients were followed up one year after their stroke. After one year, 96% of all patients reported still adhere to at least one medical stroke prevention strategy. Of the patients receiving aspirin at discharge, 92.6% reported to use that medication after 3 months and 84% after one year, while 81.6 and 61.6% were the respective figures for clopidogrel, and 85.2 and 77.4% for oral anticoagulation. Most patients who changed medication switched from aspirin to clopidogrel. Under the conditions of this observational study, adherence to stroke prevention strategies is excellent. The highest adherence rate is noticed for aspirin and oral anticoagulation. After one year, very few patients stopped taking stroke preventive medication. Copyright (C) 2003 S. Karger AG, Basel

Extreme-value statistics from Lagrangian convex hull analysis for homogeneous turbulent Boussinesq convection and MHD convection

We investigate the utility of the convex hull of many Lagrangian tracers to analyze transport properties of turbulent flows with different anisotropy. In direct numerical simulations of statistically homogeneous and stationary Navier-Stokes turbulence, neutral fluid Boussinesq convection, and MHD Boussinesq convection a comparison with Lagrangian pair dispersion shows that convex hull statistics capture the asymptotic dispersive behavior of a large group of passive tracer particles. Moreover, convex hull analysis provides additional information on the sub-ensemble of tracers that on average disperse most efficiently in the form of extreme value statistics and flow anisotropy via the geometric properties of the convex hulls. We use the convex hull surface geometry to examine the anisotropy that occurs in turbulent convection. Applying extreme value theory, we show that the maximal square extensions of convex hull vertices are well described by a classic extreme value distribution, the Gumbel distribution. During turbulent convection, intermittent convective plumes grow and accelerate the dispersion of Lagrangian tracers. Convex hull analysis yields information that supplements standard Lagrangian analysis of coherent turbulent structures and their influence on the global statistics of the flow.Comment: 18 pages, 10 figures, preprin

Fluctuation dynamo amplified by intermittent shear bursts in convectively driven magnetohydrodynamic turbulence

Intermittent large-scale high-shear flows are found to occur frequently and spontaneously in direct numerical simulations of statistically stationary turbulent Boussinesq magnetohydrodynamic (MHD) convection. The energetic steady-state of the system is sustained by convective driving of the velocity field and small-scale dynamo action. The intermittent emergence of flow structures with strong velocity and magnetic shearing generates magnetic energy at an elevated rate over time-scales longer than the characteristic time of the large-scale convective motion. The resilience of magnetic energy amplification suggests that intermittent shear-bursts are a significant driver of dynamo action in turbulent magnetoconvection

Detection of fixed points in spatiotemporal signals by clustering method

We present a method to determine fixed points in spatiotemporal signals. A 144-dimensioanl simulated signal, similar to a Kueppers-Lortz instability, is analyzed and its fixed points are reconstructed.Comment: 3 pages, 3 figure

Variational bound on energy dissipation in turbulent shear flow

We present numerical solutions to the extended Doering-Constantin variational principle for upper bounds on the energy dissipation rate in plane Couette flow, bridging the entire range from low to asymptotically high Reynolds numbers. Our variational bound exhibits structure, namely a pronounced minimum at intermediate Reynolds numbers, and recovers the Busse bound in the asymptotic regime. The most notable feature is a bifurcation of the minimizing wavenumbers, giving rise to simple scaling of the optimized variational parameters, and of the upper bound, with the Reynolds number.Comment: 4 pages, RevTeX, 5 postscript figures are available as one .tar.gz file from [email protected]

Square patterns in Rayleigh-Benard convection with rotation about a vertical axis

We present experimental results for Rayleigh-Benard convection with rotation about a vertical axis at dimensionless rotation rates in the range 0 to 250 and upto 20% above the onset. Critical Rayleigh numbers and wavenumbers agree with predictions of linear stability analysis. For rotation rates greater than 70 and close to onset, the patterns are cellular with local four-fold coordination and differ from the theoretically expected Kuppers-Lortz unstable state. Stable as well as intermittent defect-free square lattices exist over certain parameter ranges. Over other ranges defects dynamically disrupt the lattice but cellular flow and local four-fold coordination is maintained.Comment: ReVTeX, 4 pages, 7 eps figures include

Continuum-type stability balloon in oscillated granular layers

The stability of convection rolls in a fluid heated from below is limited by secondary instabilities, including the skew-varicose and crossroll instabilities. We observe a stability boundary defined by the same instabilities in stripe patterns in a vertically oscillated granular layer. Molecular dynamics simulations show that the mechanism of the skew-varicose instability in granular patterns is similar to that in convection. These results suggest that pattern formation in granular media can be described by continuum models analogous to those used in fluid systems.Comment: 4 pages, 6 ps figs, submitted to PR